COME JOIN OUR TEAM! This multi-faceted entry level position is directly responsible for providing excellent patient care and customer service! As a referrals specialist you will work to ensure that a patient's insurance allows them to access specialty services requested by their provider. You will sit in a back office setting while you work as part of a small specialized team reporting to the Clinical Operations & Referrals Manager. This dynamic role requires someone who can work efficiently, multi-task, stay calm under pressure, and be willing to be part of the positive experience every patient experiences at the Petaluma Health Center.
What We Will Bring to the Table:
- Extremely competitive benefits including: Health, Dental, and Vision coverage
- A highly energetic and fast paced environment at a growing healthcare clinic
- Generous paid time off
- Life Insurance
- Supplemental Benefit options
- Fitness Club Membership discounts
Areas of Responsibility:
- Verification of patient insurance eligibility.
- Maintains updated authorizations/referrals information in patient chart through a tracking mechanism.
- Provides assistance to uninsured patients to be enrolled in PAP program.
- Provides information to patient through warm hand offs as needed.
- Makes and/or answers phone calls regarding any referral questions.
- Assist patients in the appeals process for denial of services through the proper appeals process with their insurance companies.
- Maintain extensive resource directory for PHC staff and patients for access of community resources.
- Process all outside referrals from other PCP/specialist within expected timeframe.
- Closes 20 referrals daily.
- Tracks the completion of the referral process within expected timeframe.
- Track referrals by using structured data to maintain up to date accurate information.
- Ensures follow up with Public Health Nurse for CHDP Referrals made.
- Knowledge of managed care requirements for referrals.
- Participates in MAA Coordination and Claims Administration, including but not limited to completion of the annual time survey.
- Perform other duties as assigned by Referrals and Specialty Clinics Operations Manager or Director of Clinical Operations